Provider Demographics
NPI:1346867645
Name:GIGGETTS, LISA
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:GIGGETTS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 FORREST DR APT 306
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-1924
Mailing Address - Country:US
Mailing Address - Phone:757-298-9979
Mailing Address - Fax:
Practice Address - Street 1:20 FORREST DR APT 306
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-1924
Practice Address - Country:US
Practice Address - Phone:757-298-9979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-02
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
00000000000000OtherNONE